This study will use qualitative and statistical methods to 1) Describe the distribution of diabetes markers, health behaviors, socio-demographic characteristics and their association with oral health status outcomes of Mexican Americans by acculturation status; 2) Examine the associations between diabetes and oral health status outcomes by acculturation level for Mexican Americans; and 3) Explore the individual-level and environmental level antecedent and empowerment factors that mediate oral health utilization for Mexican Americans with diabetes by acculturation level. Research design and methodology: A statistical analysis will be conducted using the 2009-2010 National Health and Nutrition Examination Survey (NHANES) to assess the oral health status (periodontal disease status, number of teeth present, self-reported use dental floss, and self-rating of their teeth/gums) of more-and less-acculturated Mexican Americans by diabetes status. Statistical analyses for each oral health status outcome will evaluate acculturation status using [[three]] acculturation construct measures (nativity, citizenship status, language use) and relevant covariates. The results from the secondary data analyses will be used to define the thresholds of acculturation status comparisons used in four qualitative focus groups conducted with less- and more-acculturated Mexican American. The goal of these focus groups is to supplement the intricacies of the acculturation experience that are not captured by proxy measures in Specific Aim 1 and 2 and explore more in depth how individual and environmental level antecedent and empowerment factors shape intention to seek care and mediate receipt of oral health for Mexican Americans with diabetes by acculturation level. Analysis of focus groups will be inductive, using grounded theory. The results of this study will help identify the subgroup of Mexican Americans with diabetes with the highest oral health needs by acculturation status as well as provide insights on the facilitators and barriers to dental care utilization in this population. Relevance to the NIDCR's mission and research priorities: This study addresses the NIDCR's mission to apply multidisciplinary approaches to promote oral health and to prevent oral diseases and related disabilities particularly in special populations that suffer from disparities in oral diseases experienced and utilization of preventative care. Mexican Americans are the largest Latino ethnic subgroup population in the US and also have the highest level of unmet dental needs and dental care underutilization. Concurrent with disparities in oral health, Mexican Americans are also disproportionately burdened with diabetes which has been associated with several oral conditions. This study has the potential of informing tailored interventions aimed at improving the oral health and utilization of dental services for Mexican Americans with diabetes.